Anxiety or nervousness can cause kids and adults to have “butterflies” in their stomach just an unfriendly feeling. And, it can sometimes cause sharp pain too. It’s always good to check these problems out with your pediatrician or family doctor before assuming that they are of a nervous nature. Sometimes it’s hard to tell.

When Mary, age 12, has a test at school the next day, she is sure to have butterflies the night before. She loses her appetite and feels bad. It’s often worse in the morning, but after the test is over, she’s her usual perky self. Joey, can have a sharp pain in his gut a few hours before a soccer game. He is fearful that he will mess up. Always the perfectionist, he can’t stand it if he misses the goal!

Sometimes it’s difficult to know whether these symptoms are related to stress, something your youngster ate (or shouldn’t have eaten), or a virus. But for many children, when nerves are the culprit, a pattern will emerge that is pretty consistent.

A recent article in The New York Times (August 12, 2013) described a study at Vanderbilt University. Researchers followed 332 children with recurring stomaches that could not be traced to a physical cause—called “functional abdominal pain”, comparing them, as they became young adults with 147 children who didn’t have these kinds of stomachaches.

About half of the kids who had functional stomachaches as young children developed anxiety problems as teens or young adults, while only 20% of the control group displayed these concerns. This difference was statistically significant. According to the article, 8-25% of school aged children can have functional stomachaches. These symptoms can lead to school absences, missed activities, and stress for their families.

As adults, we are more aware of those events which are likely to cause us “anticipatory anxiety”—that is, nervousness about an event or activity before it occurs. Children have difficulty connecting their performance anxiety or nervousness about an event with their physical distress. They just want it to go away!

It can be very challenging for parents. How can they help their child feel better? What can they do? Should they keep their kid home from school? Should she miss the birthday party? These decisions can be very difficult.

According to the article—“The state-of-the-art treatment for functional abdominal pain is rehabilitative, focused on getting patients to participate in daily activities despite their stomachaches.” Avoiding the triggers that ignite stomach pain or distress will just make them worse in the future. Too much missed school can turn into a major school avoidance problem. We don’t want children to learn to cope with anxiety by avoidance. It is not a healthy coping skill.

If your child has regular stomach pain or distress, here are some suggestions.

First, schedule a visit with your pediatrician, nurse practitioner, or family doctor. It is important to rule out any organic problems which may be the cause. My niece had frequent stomach pain. Her parents were convinced she had a “nervous stomach”, but it turned out later she had gallstones! Ouch!

Try a hot water bottle. A hot water bottle on her tummy can calm tight muscles and relieve discomfort. A hot bath or shower can also help.

Give a back massage. A gentle back massage can release tight muscles made tense by anxiety. It can help your child relax.

Teach your child how to take long slow breaths. Long, slow abdominal breathing can help adults and children relax!

Have your child see a mental health specialist. If these concerns become troubling, ask your child’s primary care doctor for a referral to a mental health counselor. We can help your child learn skills to manage their anxiety and pain before it turns into a major problem. Early intervention can make a big difference, especially now that we know that many of these kids will have anxiety problems later on.

Comments

Submitted by Anonymous on Thu, 09/19/2013 - 10:06am

My daughter was the same whenever there were tests at school, and with anything that was out of her normal routine. The anxiety got worse, meetings would mean she would not eat until after them, even if they were in the afternoon. She went to a councellor to learn how to deal with the anxiety and she continues to use what she learned. Talking to her manager so she would understand helped with meetings. She now does things, going to concerts etc that make her uncomfortable, and finds afterwards that she has enjoyed herself, and is happy she has not let her anxiety stop her form enjoying life.

Submitted by Kierstine on Thu, 09/19/2013 - 10:09am

I had a lot of anxiety stomach aches when i was little. Even when i was a toddler, i would have them. What my mom did was have me sit on the couch with her and just close my eyes, take 15 minutes to breath deeply and relax. After i would be a different kid. I notice even now, i have those same aches when something nerve-racking is coming or if i'm even excited for something. But because i learned to deal with it as a child, i can help myself now, and hopefully my kids in the future

Submitted by Anonymous on Thu, 09/19/2013 - 2:42pm

As a middle schooler I had many stomach issues. I went to several doctors to seek help. Nothing ever made it better. I remember one doctor asking me if I worried alot, but since my mother was in the room with me, I lied and said no. As an adult I have anxiety severe enough to impact my daily life. I am getting better as I get older. Thank you Dr Paul for raising this issue. Hopefully parents can find an approach to the "nervous stomach" in a way their child is comfortable discussing.